Aminoglycosides
The type of medication aminoglycosides are
Antibiotic
The reason we maintain dosages within a strict therapeutic range
To avoid unacceptable toxicities
The major site for metabolism
Liver
The organ most responsible for excretion
Kidney
Name 2 blood tests that assess kidney function
BUN, urea, creatinine, eGFR
The 3 most common aminoglycosides
Gentamicin, tobramycin and amikacin
What likelihood is increased when using medications with narrow therapeutic indexes
adverse reactions
What is metabolism?
biochemical alteration of a drug into any of the following:
inactive metabolite, more soluble compound, more potent metabolite
2 organs that are not the primary that play a role in excretion of drugs
The liver and the bowel
What is the trough level of a drug?
The lowest blood level of a drug (taken right before the next dose is administered)
The 2 types of complications associated with aminoglycosides
Nephrotoxicity and Ototoxicity
What is the onset?
The amount of drug to get minimal effective concentration
The enzymes involved in hepatic metabolism
Cytochrome p450
What changes made to drugs by the liver make it easier for kidneys to eliminate them
Drugs become more polar and water-soluble. The urinary tract is water-based
What are 2 drugs with narrow therapeutic indexes?
warfarin, heparin, phenytoin, digoxin, lithium, cyclosporine, methotrexate, carbamazepine
The minimum inhibitory concentration
The lowest concentration of drug needed to kill a standard amount of bacteria
What is drug concentration?
Amount of drug in a given volume of blood plasma
What happens to a prodrug when it is metabolized
It's converted to its active form
What is the half-life
The amount of time required for serum drug levels to be reduced by one-half during the elimination phase
What is diagnostic testing of drug concentrations in the blood useful for assessing? (name 1)
-adequate concentrations to achieve therapeutic effect are being achieved
- if potentially toxic concentrations are being reached
-patients are adhering to the prescribed medication regimen
The dosing is adjusted based on this
The ratio of these two things are referred to as the drug's therapeutic index
the ratio of a drug's toxic level to the level that provides therapeutic benefits
2 variables that can affect drug metabolism
Age, Drugs, Disease, Genetics
2 variables that can affect drug elimination
Age, disease (renal failure), drug toxicity, genetics
You have a peak level of a drug that is 240mg/mL. The half life is 4 hrs. What will the measured level of the drug be in 8 hrs.
60 mg/mL